Official publication of Rawalpindi Medical University
Close Reduction And Percutaneous Pinning (Crpp) Versus Open Reduction And Internal Fixation (Orif) For Fracture Of Lateral Condyle Of Humerus In Children

How to Cite

1.
Akhtar RR, Ashraf N, Ahmed R, Arif A, Sajid M, Waris H. Close Reduction And Percutaneous Pinning (Crpp) Versus Open Reduction And Internal Fixation (Orif) For Fracture Of Lateral Condyle Of Humerus In Children. JRMC [Internet]. 2025 Dec. 31 [cited 2025 Dec. 31];29(4). Available from: https://journalrmc.com/index.php/JRMC/article/view/2932

Abstract

Objective: To compare the functional outcome of CRPP with ORIF for fracture of the lateral condyle of the humerus in children.

Methods: This randomised control study was conducted in the Orthopaedics Department, Rawalpindi Medical University, Rawalpindi, from 10th January 2021 to 10th July 2021. It included 60 patients aged 2 to 12 years who presented with type II lateral condyle of humerus fracture, according to Jakob’s classification. An equal number of participants, i.e., 30, were assigned to each group: the CRPP and ORIF groups. Randomisation was performed by the lottery method. The functional outcome was assessed at the 2nd month postoperatively by using modified Aggarwal criteria.

Results: The patient’s age range was 2 to 12 years, and male gender was dominant in both groups. Functional outcome was excellent (93.3%) in the CRPP group as compared to the ORIF group (73.3%), good (6.7%) in the CRPP group versus 10%, fair (0%) in the CRPP group versus 10% and poor (0%) in the CRPP group versus 6.7% (p=0.116).

Conclusion: CRPP could be the treatment of choice as the frequency of functional outcome of closed reduction and percutaneous pinning is statistically similar to that of ORIF.

Keywords: Humeral fracture, closed reduction, Lateral condyle fracture, Displaced, open reduction

https://doi.org/10.37939/jrmc.v29i4.2932

References

El-Adly W, El-Mowafi H, El-Hadidi M, et al. Management of displaced lateral humeral condyle fractures in children: CRPP versus ORIF. J Orthop Surg Res. 2021; 16(1):498. DOI: 10.1186/s13018-021-02648-3.

Patel S, Patel N, Shah H, et al. Functional and radiological outcomes of closed vs. open reduction in pediatric lateral condyle fractures: a multicenter study. Injury. 2022; 53(3):1022–1027. DOI: 10.1016/j.injury.2021.11.011.

Meena S, Sharma P, Sambharia A, et al. CRPP versus ORIF in pediatric lateral condyle fractures: a randomised controlled trial. J Orthop Trauma. 2023; 37(4):e183–e189. DOI: 10.1097/BOT.0000000000002512.

Zale C, Winthrop ZA, Hennrikus W. Rate of displacement for Jakob Type 1 lateral condyle fractures treated with a cast. Journal of children's orthopaedics. 2018; 12(2):117-22. DOI: 10.1302/1863-2548.12.170124.

Tepeneu NF. Fractures of the Condyles ofhumerus in Children – A Review. Journal of Medical and Psychological Trauma. 2018; 1(1):3-13. DOI: 10.14302/issn.2766-6204.jmpt-17-1913.

Marcheix PS, Vacquerie V, Longis B, Peyrou P, Fourcade L, Moulies D. Percutaneous pinning versus open reduction internal fixation in pediatric lateral condyle fractures: a prospective cohort study. Eur J Orthop Surg Traumatol. 2020; 30(4):623-628.

Li J, Rai S, Tang X, Ze R, Liu R, Hong P. Comparative study of closed reduction percutaneous pinning versus open reduction internal fixation for pediatric lateral condyle humerus fractures. J Pediatr Orthop. 2021; 41(3):e222-e227. DOI: 10.1097/BPO.0000000000001725.

Bauer AS, Bae DS, Brustowicz KA, Waters PM. Intra-articular displacement as a predictor of outcomes in pediatric lateral condyle fractures treated with closed or open reduction. J Pediatr Orthop B. 2021; 30(2):123-129. DOI: 10.1097/BPB.0000000000000753.

Chen Y, Li X, Zhang H, Wang J, Zhao L. A prospective randomized study comparing percutaneous pinning and open reduction for pediatric lateral condyle fractures of the humerus. Int Orthop. 2022; 46(5):1135-1142. DOI: 10.1007/s00264-022-05338-9.

Kumar A, Verma A, Yadav A, et al. CRPP vs. ORIF in pediatric lateral condyle fractures: a systematic review and meta-analysis. J Pediatr Orthop. 2023; 43(2):e153–e160. DOI: 10.1097/BPO.0000000000002291.

Pennock A, Salgueiro L, Upasani V, P Bastrom T, O Newton P, Yaszay B. Closed Reduction and Percutaneous Pinning Versus Open Reduction and Internal Fixation for Type II Lateral Condyle Humerus Fractures in Children Displaced >2 mm. Journal of Pediatric Orthopaedics. 2016; 36(8):7. DOI: 10.1097/BPO.0000000000000570.

Silva M, Cooper SD. Closed Reduction and the Per-cutaneous Pinning of Displaced Pediatric Lateral Condyle Fractures of the Humerus: A Cohort Study. Journal of Pediatric Orthopaedics. 2015; 35(7):661-5. DOI: 10.1097/BPO.0000000000000376.

Stevenson RA, Perry DC. Paediatric lateral condyle fractures of the distal humerus. Orthopaedics and Trauma. 2018; 32(5):352-9. DOI: 10.1016/j.mporth.2018.07.013.

Ganeshalingam R, Donnan A, Evans O, et al. Lateral condyle fractures of the humerus in children: does operative strategy affect outcomes?. J Pediatr Orthop B. 2022; 31(3):239–245. DOI: 10.1097/BPB.0000000000000887.

Sharma A, Gupta N, Singh A, et al. Functional outcomes of CRPP versus ORIF in displaced lateral condyle fractures of the humerus in children: a prospective randomized study. J Clin Orthop Trauma. 2023; 36:102074. DOI: 10.1016/j.jcot.2022.102074.

Lee RJ, Weiss JM, Eberson CP, Hresko MT, Hedequist DJ. Closed reduction and percutaneous pinning versus open reduction and internal fixation for pediatric lateral condyle fractures: a multicenter analysis. J Pediatr Orthop. 2021; 41(10):e876-e881. DOI: 10.1097/BPO.0000000000001965.

Singh KA, Shah H, Joseph B, Nayeemuddin M. Comparison of complications and radiographic outcomes between CRPP and ORIF in pediatric lateral condyle fractures: a retrospective cohort study. J Orthop Surg Res. 2022; 17(1):452. DOI: 10.1186/s13018-022-03340-w.

Marcheix PS, Vacquerie V, Longis B, Peyrou P, Fourcade L, Moulies D. Percutaneous pinning versus open reduction internal fixation in pediatric lateral condyle fractures: a prospective cohort study. Eur J Orthop Surg Traumatol. 2020; 30(4):623-628. DOI: 10.1007/s00590-019-02607-z.

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Copyright (c) 2025 Rahman Rasool Akhtar, Nauman Ashraf, Riaz Ahmed, Adnan Arif, Muhammad Sajid, Hira Waris